Appropriate eFfective eFficient Oncology Reimbursement Decisions

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Past Research

Expansion of the Research Program into Europe

The AFFORD study will be expanding in scope into Poland and Germany. We plan on studying the formulary processes in these two countries to understand how decisions regarding drug reimbursement are made in Europe, and how this compares to the Canadian processes. The study proposal(in Polish) outlines the goals, objectives and planned methods for the study. A research planning meeting will be held in Warsaw on February 17th, 2016. Please click here for an invitationto the meeting.

ARCC pilot study

Through pilot research by our team, challenges using economic evidence in the drug funding recommendation process were observed. The nature of the problem was explored further by our team with a pilot study funded by the Canadian Centre for Applied Research in Cancer Control (ARCC), in which members of the Nova Scotia drug recommendation committee (the Nova Scotia Cancer Systemic Therapy Policy Committee) were interviewed.

The purpose of the ARCC-funded study was to pilot research instruments for the AFFORD study, and to support the hypothesized gap between knowledge producers and users. Results of the pilot study confirm that there is a dissonance between health economists and decision makers in their understanding of intended and actual use of health economic evidence. For the pilot study, decision makers were members of the Nova Scotia Cancer Systemic Therapy Policy Committee, an advisory to the Minister of Health. Decision makers perceived challenges within the micro-context of the committee, whereas health economists identified broader challenges with respect to information availability, technical aspects, and timing.

Given that the pilot was conducted with decision makers as respondents in qualitative interviews, the results of the study provide a clear indication of decision-makers’ needs. The interviews highlighted a discrepancy in perception between producers and users of economic evidence in terms of intended and actual use. The study also identified an apprehension with the relative role that economic evidence should play in a multi-criteria setting, and a tendency for clinical evidence to become the sole focus. As such, the pilot study influenced the focus of the AFFORD project to one of understanding the expectations of knowledge users and producers, and understanding of the process of balancing multiple criteria in decision making.